Zambia Immunizations FHIR Implementation Guide
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Zambia Immunizations FHIR Implementation Guide, published by Jembi Health Systems. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/jembi/Zambia-Immunizations/ and changes regularly. See the Directory of published versions

Resource Profile: RelationToPatient - Detailed Descriptions

Active as of 2024-09-30

Definitions for the relation-to-patient resource profile.

Guidance on how to interpret the contents of this table can be found here

0. RelatedPerson
2. RelatedPerson.identifier
Definition

reason(s) why this should be supported.

NoteThis is a business identifier, not a resource identifier (see discussion)
Must Supporttrue
SlicingThis element introduces a set of slices on RelatedPerson.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ system
  • 4. RelatedPerson.identifier:NRC
    Slice NameNRC
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1
    Must Supporttrue
    6. RelatedPerson.identifier:NRC.system
    Control1..?
    Pattern Valuehttp://moh.gov.zm/fhir/immunizations/identifier/relative-nrc
    8. RelatedPerson.identifier:NRC.value
    Control1..?
    InvariantsNRC-SmartcareID-1: Only special characters (forward slash) and numbers are allowed. For example: 999999/99/9 ($this.matches('^[0-9]{1,6}/[0-9]{1,2}/[0-9]{1}$'))
    10. RelatedPerson.name
    Definition

    reason(s) why this should be supported.

    Must Supporttrue
    12. RelatedPerson.name.use
    Control1..?
    14. RelatedPerson.name.family
    Definition

    reason(s) why this should be supported.

    Must Supporttrue
    16. RelatedPerson.name.given
    Definition

    reason(s) why this should be supported.

    Control0..1
    Must Supporttrue
    18. RelatedPerson.telecom
    SlicingThis element introduces a set of slices on RelatedPerson.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • 20. RelatedPerson.telecom:phone
      Slice Namephone
      Definition

      reason(s) why this should be supported.

      Control0..1
      Must Supporttrue
      22. RelatedPerson.telecom:phone.system
      Control1..?
      Pattern Valuephone
      24. RelatedPerson.telecom:phone.value
      Control1..?
      InvariantsPHONE-1: Only special characters (+) and numbers are allowed. For example: 0831231234, +27831231234 ($this.matches('^[+]?{1}[0-9]{10,12}$'))

      Guidance on how to interpret the contents of this table can be found here

      0. RelatedPerson
      Definition

      Information about a person that is involved in a patient's health or the care for a patient, but who is not the target of healthcare, nor has a formal responsibility in the care process.

      ShortA person that is related to a patient, but who is not a direct target of care
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. RelatedPerson.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. RelatedPerson.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

      Control0..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      6. RelatedPerson.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Must Supportfalse
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. RelatedPerson.identifier
      Definition

      reason(s) why this should be supported.


      Identifier for a person within a particular scope.

      ShortA human identifier for this person
      Comments

      RelatedPerson identifiers might not be unique across instances within a system, as a single human individual may be represented as many different RelatedPerson resources with different roles, periods, or relationships.

      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      People are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the patient. Examples are national person identifier and local identifier.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on RelatedPerson.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ system
      • 10. RelatedPerson.identifier:NRC
        Slice NameNRC
        Definition

        Identifier for a person within a particular scope.

        ShortA human identifier for this person
        Comments

        RelatedPerson identifiers might not be unique across instances within a system, as a single human individual may be represented as many different RelatedPerson resources with different roles, periods, or relationships.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..1*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        People are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the patient. Examples are national person identifier and local identifier.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. RelatedPerson.identifier:NRC.use
        Definition

        The purpose of this identifier.

        Shortusual | official | temp | secondary | old (If known)
        Comments

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Control0..1
        BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|5.0.0
        (required to http://hl7.org/fhir/ValueSet/identifier-use|5.0.0)

        Identifies the purpose for this identifier, if known .

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. RelatedPerson.identifier:NRC.system
        Definition

        Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control10..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

        Pattern Valuehttp://moh.gov.zm/fhir/immunizations/identifier/relative-nrc
        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. RelatedPerson.identifier:NRC.value
        Definition

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        ShortThe value that is unique
        Comments

        If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Control10..1
        This element is affected by the following invariants: ident-1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Example<br/><b>General</b>:123456
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        NRC-SmartcareID-1: Only special characters (forward slash) and numbers are allowed. For example: 999999/99/9 ($this.matches('^[0-9]{1,6}/[0-9]{1,2}/[0-9]{1}$'))
        18. RelatedPerson.active
        Definition

        Whether this related person record is in active use.

        ShortWhether this related person's record is in active use
        Comments

        This element is labeled as a modifier because it may be used to mark that the resource was created in error.

        Control0..1
        Typeboolean
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Requirements

        Need to be able to mark a related person record as not to be used, such as if it was created in error.

        Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. RelatedPerson.patient
        Definition

        The patient this person is related to.

        ShortThe patient this person is related to
        Control1..1
        TypeReference(Patient)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Requirements

        We need to know which patient this RelatedPerson is related to.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. RelatedPerson.name
        Definition

        reason(s) why this should be supported.


        A name associated with the person.

        ShortA name associated with the person
        Control0..*
        TypeHumanName
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Related persons need to be identified by name, but it is uncommon to need details about multiple other names for that person.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. RelatedPerson.name.use
        Definition

        Identifies the purpose for this name.

        Shortusual | official | temp | nickname | anonymous | old | maiden
        Comments

        Applications can assume that a name is current unless it explicitly says that it is temporary or old.

        Control10..1
        BindingThe codes SHALL be taken from NameUsehttp://hl7.org/fhir/ValueSet/name-use|5.0.0
        (required to http://hl7.org/fhir/ValueSet/name-use|5.0.0)

        The use of a human name.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Allows the appropriate name for a particular context of use to be selected from among a set of names.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. RelatedPerson.name.family
        Definition

        reason(s) why this should be supported.


        The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

        ShortFamily name (often called 'Surname')
        Comments

        Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Alternate Namessurname
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. RelatedPerson.name.given
        Definition

        reason(s) why this should be supported.


        Given name.

        ShortGiven names (not always 'first'). Includes middle names
        Comments

        If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

        Control0..1*
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Alternate Namesfirst name, middle name
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. RelatedPerson.telecom
        Definition

        A contact detail for the person, e.g. a telephone number or an email address.

        ShortA contact detail for the person
        Comments

        Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

        Control0..*
        TypeContactPoint
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Requirements

        People have (primary) ways to contact them in some way such as phone, email.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on RelatedPerson.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ system
        • 32. RelatedPerson.telecom:phone
          Slice Namephone
          Definition

          reason(s) why this should be supported.


          A contact detail for the person, e.g. a telephone number or an email address.

          ShortA contact detail for the person
          Comments

          Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

          Control0..1*
          TypeContactPoint
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          People have (primary) ways to contact them in some way such as phone, email.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. RelatedPerson.telecom:phone.system
          Definition

          Telecommunications form for contact point - what communications system is required to make use of the contact.

          Shortphone | fax | email | pager | url | sms | other
          Control10..1
          This element is affected by the following invariants: cpt-2
          BindingThe codes SHALL be taken from ContactPointSystemhttp://hl7.org/fhir/ValueSet/contact-point-system|5.0.0
          (required to http://hl7.org/fhir/ValueSet/contact-point-system|5.0.0)

          Telecommunications form for contact point.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Pattern Valuephone
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. RelatedPerson.telecom:phone.value
          Definition

          The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

          ShortThe actual contact point details
          Comments

          Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

          Control10..1
          This element is affected by the following invariants: cpt-2
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to support legacy numbers that are not in a tightly controlled format.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          PHONE-1: Only special characters (+) and numbers are allowed. For example: 0831231234, +27831231234 ($this.matches('^[+]?{1}[0-9]{10,12}$'))
          38. RelatedPerson.telecom:phone.use
          Definition

          Identifies the purpose for the contact point.

          Shorthome | work | temp | old | mobile - purpose of this contact point
          Comments

          Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

          Control0..1
          BindingThe codes SHALL be taken from ContactPointUsehttp://hl7.org/fhir/ValueSet/contact-point-use|5.0.0
          (required to http://hl7.org/fhir/ValueSet/contact-point-use|5.0.0)

          Use of contact point.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

          Guidance on how to interpret the contents of this table can be found here

          0. RelatedPerson
          Definition

          Information about a person that is involved in a patient's health or the care for a patient, but who is not the target of healthcare, nor has a formal responsibility in the care process.

          ShortA person that is related to a patient, but who is not a direct target of care
          Control0..*
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. RelatedPerson.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

          Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

          Control0..1
          Typeid
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          4. RelatedPerson.meta
          Definition

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. RelatedPerson.implicitRules
          Definition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          Comments

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. RelatedPerson.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

          Control0..1
          BindingThe codes SHALL be taken from AllLanguages
          (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

          IETF language tag for a human language

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. RelatedPerson.text
          Definition

          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

          ShortText summary of the resource, for human interpretation
          Comments

          Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

          Control0..1
          This element is affected by the following invariants: dom-6
          TypeNarrative
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. RelatedPerson.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

          ShortContained, inline Resources
          Comments

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

          Control0..*
          This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
          TypeResource
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. RelatedPerson.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          16. RelatedPerson.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Must Supportfalse
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          18. RelatedPerson.identifier
          Definition

          reason(s) why this should be supported.

          ShortA human identifier for this person
          Comments

          RelatedPerson identifiers might not be unique across instances within a system, as a single human individual may be represented as many different RelatedPerson resources with different roles, periods, or relationships.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          People are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the patient. Examples are national person identifier and local identifier.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on RelatedPerson.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ system
          • 20. RelatedPerson.identifier:NRC
            Slice NameNRC
            Definition

            Identifier for a person within a particular scope.

            ShortA human identifier for this person
            Comments

            RelatedPerson identifiers might not be unique across instances within a system, as a single human individual may be represented as many different RelatedPerson resources with different roles, periods, or relationships.

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            People are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the patient. Examples are national person identifier and local identifier.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. RelatedPerson.identifier:NRC.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            This element is affected by the following invariants: ele-1
            Typeid
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            24. RelatedPerson.identifier:NRC.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on RelatedPerson.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 26. RelatedPerson.identifier:NRC.use
              Definition

              The purpose of this identifier.

              Shortusual | official | temp | secondary | old (If known)
              Comments

              Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

              Control0..1
              BindingThe codes SHALL be taken from IdentifierUse
              (required to http://hl7.org/fhir/ValueSet/identifier-use|5.0.0)

              Identifies the purpose for this identifier, if known .

              Typecode
              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              28. RelatedPerson.identifier:NRC.type
              Definition

              A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

              ShortDescription of identifier
              Comments

              This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from IdentifierTypeCodes
              (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

              A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows users to make use of identifiers when the identifier system is not known.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              30. RelatedPerson.identifier:NRC.system
              Definition

              Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.

              ShortThe namespace for the identifier value
              Comments

              Identifier.system is always case sensitive.

              Control1..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

              Pattern Valuehttp://moh.gov.zm/fhir/immunizations/identifier/relative-nrc
              Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. RelatedPerson.identifier:NRC.value
              Definition

              The portion of the identifier typically relevant to the user and which is unique within the context of the system.

              ShortThe value that is unique
              Comments

              If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the http://hl7.org/fhir/StructureDefinition/rendered-value). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

              Control1..1
              This element is affected by the following invariants: ident-1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Example<br/><b>General</b>:123456
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              NRC-SmartcareID-1: Only special characters (forward slash) and numbers are allowed. For example: 999999/99/9 ($this.matches('^[0-9]{1,6}/[0-9]{1,2}/[0-9]{1}$'))
              34. RelatedPerson.identifier:NRC.period
              Definition

              Time period during which identifier is/was valid for use.

              ShortTime period when id is/was valid for use
              Control0..1
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. RelatedPerson.identifier:NRC.assigner
              Definition

              Organization that issued/manages the identifier.

              ShortOrganization that issued id (may be just text)
              Comments

              The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

              Control0..1
              TypeReference(Organization)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. RelatedPerson.active
              Definition

              Whether this related person record is in active use.

              ShortWhether this related person's record is in active use
              Comments

              This element is labeled as a modifier because it may be used to mark that the resource was created in error.

              Control0..1
              Typeboolean
              Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supportfalse
              Summarytrue
              Requirements

              Need to be able to mark a related person record as not to be used, such as if it was created in error.

              Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. RelatedPerson.patient
              Definition

              The patient this person is related to.

              ShortThe patient this person is related to
              Control1..1
              TypeReference(Patient)
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Requirements

              We need to know which patient this RelatedPerson is related to.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. RelatedPerson.relationship
              Definition

              The nature of the relationship between the related person and the patient.

              ShortThe relationship of the related person to the patient
              Comments

              The directionality of the relationship is from the RelatedPerson to the Patient. For example, if the Patient is a child, and the RelatedPerson is the mother, the relationship would be PRN (parent) or MTH (mother).

              Control0..*
              BindingThe codes SHOULD be taken from PatientRelationshipType
              (preferred to http://hl7.org/fhir/ValueSet/relatedperson-relationshiptype)

              The nature of the relationship between a patient and the related person.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Requirements

              We need to know the relationship with the patient since it influences the interpretation of the information attributed to this person.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              44. RelatedPerson.name
              Definition

              reason(s) why this should be supported.

              ShortA name associated with the person
              Control0..*
              TypeHumanName
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Related persons need to be identified by name, but it is uncommon to need details about multiple other names for that person.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              46. RelatedPerson.name.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              This element is affected by the following invariants: ele-1
              Typeid
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              48. RelatedPerson.name.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on RelatedPerson.name.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 50. RelatedPerson.name.use
                Definition

                Identifies the purpose for this name.

                Shortusual | official | temp | nickname | anonymous | old | maiden
                Comments

                Applications can assume that a name is current unless it explicitly says that it is temporary or old.

                Control1..1
                BindingThe codes SHALL be taken from NameUse
                (required to http://hl7.org/fhir/ValueSet/name-use|5.0.0)

                The use of a human name.

                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old name etc.for a current/permanent one
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Allows the appropriate name for a particular context of use to be selected from among a set of names.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                52. RelatedPerson.name.text
                Definition

                Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

                ShortText representation of the full name
                Comments

                Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                A renderable, unencoded form.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                54. RelatedPerson.name.family
                Definition

                reason(s) why this should be supported.

                ShortFamily name (often called 'Surname')
                Comments

                Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Alternate Namessurname
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                56. RelatedPerson.name.given
                Definition

                reason(s) why this should be supported.

                ShortGiven names (not always 'first'). Includes middle names
                Comments

                If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Alternate Namesfirst name, middle name
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                58. RelatedPerson.name.prefix
                Definition

                Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

                ShortParts that come before the name
                Control0..*
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                60. RelatedPerson.name.suffix
                Definition

                Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

                ShortParts that come after the name
                Control0..*
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                62. RelatedPerson.name.period
                Definition

                Indicates the period of time when this name was valid for the named person.

                ShortTime period when name was/is in use
                Control0..1
                TypePeriod
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows names to be placed in historical context.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. RelatedPerson.telecom
                Definition

                A contact detail for the person, e.g. a telephone number or an email address.

                ShortA contact detail for the person
                Comments

                Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

                Control0..*
                TypeContactPoint
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Requirements

                People have (primary) ways to contact them in some way such as phone, email.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on RelatedPerson.telecom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ system
                • 66. RelatedPerson.telecom:phone
                  Slice Namephone
                  Definition

                  reason(s) why this should be supported.

                  ShortA contact detail for the person
                  Comments

                  Person may have multiple ways to be contacted with different uses or applicable periods. May need to have options for contacting the person urgently, and also to help with identification.

                  Control0..1
                  TypeContactPoint
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  People have (primary) ways to contact them in some way such as phone, email.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  68. RelatedPerson.telecom:phone.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typeid
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  70. RelatedPerson.telecom:phone.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on RelatedPerson.telecom.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 72. RelatedPerson.telecom:phone.system
                    Definition

                    Telecommunications form for contact point - what communications system is required to make use of the contact.

                    Shortphone | fax | email | pager | url | sms | other
                    Control1..1
                    This element is affected by the following invariants: cpt-2
                    BindingThe codes SHALL be taken from ContactPointSystem
                    (required to http://hl7.org/fhir/ValueSet/contact-point-system|5.0.0)

                    Telecommunications form for contact point.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Pattern Valuephone
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    74. RelatedPerson.telecom:phone.value
                    Definition

                    The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

                    ShortThe actual contact point details
                    Comments

                    Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

                    Control1..1
                    This element is affected by the following invariants: cpt-2
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to support legacy numbers that are not in a tightly controlled format.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    PHONE-1: Only special characters (+) and numbers are allowed. For example: 0831231234, +27831231234 ($this.matches('^[+]?{1}[0-9]{10,12}$'))
                    76. RelatedPerson.telecom:phone.use
                    Definition

                    Identifies the purpose for the contact point.

                    Shorthome | work | temp | old | mobile - purpose of this contact point
                    Comments

                    Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

                    Control0..1
                    BindingThe codes SHALL be taken from ContactPointUse
                    (required to http://hl7.org/fhir/ValueSet/contact-point-use|5.0.0)

                    Use of contact point.

                    Typecode
                    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    78. RelatedPerson.telecom:phone.rank
                    Definition

                    Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

                    ShortSpecify preferred order of use (1 = highest)
                    Comments

                    Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

                    Ranks need not be unique. E.g. it's possible to have multiple contacts with rank=1. If the ranks have different systems or uses, this would be interpreted to mean "X is my most preferred phone number, Y is my most preferred email address" or "X is my preferred home email and Y is my preferred work email". If the system and use for equally-ranked contacts are the same, then the level of preference is equivalent for both repetitions.

                    Ranks need not be sequential and not all repetitions must have a rank. For example, it's possible to have 4 contacts with ranks of 2, 5 and two with no rank specified. That would be interpreted to mean the first is preferred over the second and no preference stated for the remaining contacts.

                    Control0..1
                    TypepositiveInt
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    80. RelatedPerson.telecom:phone.period
                    Definition

                    Time period when the contact point was/is in use.

                    ShortTime period when the contact point was/is in use
                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    82. RelatedPerson.gender
                    Definition

                    Administrative Gender - the gender that the person is considered to have for administration and record keeping purposes.

                    Shortmale | female | other | unknown
                    Control0..1
                    BindingThe codes SHALL be taken from AdministrativeGender
                    (required to http://hl7.org/fhir/ValueSet/administrative-gender|5.0.0)

                    The gender of a person used for administrative purposes.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supportfalse
                    Summarytrue
                    Requirements

                    Needed for identification of the person, in combination with (at least) name and birth date.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    84. RelatedPerson.birthDate
                    Definition

                    The date on which the related person was born.

                    ShortThe date on which the related person was born
                    Control0..1
                    Typedate
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supportfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    86. RelatedPerson.address
                    Definition

                    Address where the related person can be contacted or visited.

                    ShortAddress where the related person can be contacted or visited
                    Control0..*
                    TypeAddress
                    Is Modifierfalse
                    Must Supportfalse
                    Summarytrue
                    Requirements

                    Need to keep track where the related person can be contacted per postal mail or visited.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    88. RelatedPerson.photo
                    Definition

                    Image of the person.

                    ShortImage of the person
                    Control0..*
                    TypeAttachment
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Requirements

                    Many EHR systems have the capability to capture an image of persons. Fits with newer social media usage too.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    90. RelatedPerson.period
                    Definition

                    The period of time during which this relationship is or was active. If there are no dates defined, then the interval is unknown.

                    ShortPeriod of time that this relationship is considered valid
                    Comments

                    If an individual has a relationship with a patient over multiple, non-adjacent periods, there should be a distinct RelatedPerson instance for each period. For example, if a person is a roommate for a period of time, moves out, and is later a roommate with the same person again, you would have two RelatedPerson instances.

                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    92. RelatedPerson.communication
                    Definition

                    A language which may be used to communicate with the related person about the patient's health.

                    ShortA language which may be used to communicate with the related person about the patient's health
                    Comments

                    If no language is specified, this implies that the default local language is spoken. If you need to convey proficiency for multiple modes, then you need multiple RelatedPerson.Communication associations. If the RelatedPerson does not speak the default local language, then the Interpreter Required Standard can be used to explicitly declare that an interpreter is required.

                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Requirements

                    If a related person does not speak the local language, interpreters may be required, so languages spoken and proficiency is an important things to keep track of both for patient and other persons of interest.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    94. RelatedPerson.communication.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    96. RelatedPerson.communication.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    98. RelatedPerson.communication.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    100. RelatedPerson.communication.language
                    Definition

                    The ISO-639-1 alpha 2 code in lower case for the language, optionally followed by a hyphen and the ISO-3166-1 alpha 2 code for the region in upper case; e.g. "en" for English, or "en-US" for American English versus "en-AU" for Australian English.

                    ShortThe language which can be used to communicate with the related person about the patient's health
                    Comments

                    The structure aa-BB with this exact casing is one the most widely used notations for locale. However not all systems actually code this but instead have it as free text. Hence CodeableConcept instead of code as the data type.

                    Control1..1
                    BindingThe codes SHALL be taken from AllLanguages
                    (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

                    IETF language tag for a human language

                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Requirements

                    Most systems in multilingual countries will want to convey language. Not all systems actually need the regional dialect.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    102. RelatedPerson.communication.preferred
                    Definition

                    Indicates whether or not the related person prefers this language (over other languages he or she masters up a certain level).

                    ShortLanguage preference indicator
                    Comments

                    This language is specifically identified for communicating healthcare information.

                    Control0..1
                    Typeboolean
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supportfalse
                    Summaryfalse
                    Requirements

                    People that master multiple languages up to certain level may prefer one or more, i.e. feel more confident in communicating in a particular language making other languages sort of a fall back method.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))